Vaginal birth vs C-section: which one to go for?

WHY ARE C-SECTIONS NOTTHE NORM?
When it comes to breech births, only four to five per cent of pregnancies, globally, tend to display breech presentation and require medical intervention. And yet, many women have the erroneous notion that a C-section is preferable over a vaginal birth because it means they will experience less pain, discomfort and completely avoid any chance of vaginal stretching or incidents of episiotomies (surgical cutting to temporarily widen the vagina). Several unscrupulous medical personnel are also responsible for scheduling C-sections even when not strictly required, because it assures the medical facility of higher revenue.

Typically, a C-section patient’s stayin till she recovers from the surgery is roughly a few days as opposed to a few hours in the case of vaginal birth. The mother may breastfeed the baby almost immediately after she’s out of the operation theatre and wakes up from the surgery. Yet, she needs to be kept in the hospital for observation to monitor her vitals and avoid any incidence of amniotic fluid embolism and postpartum bleeding, which are surprisingly common post C-section.

Even the baby is not safe from complications when delivered via a C-section. Any of the following could occur:

Wet lung: Retention of fluid in the lungs can occur if not expelled by the pressure of contractions during labour. Potential for early delivery and complications: Preterm delivery may be inadvertently carried out if due-date calculation is inaccurate. One study found an increased complication risk if a repeat elective caesarean section is performed even a few days before the recommended 39 weeks.

Higher infant mortality risk: In caesarean sections performed with no indicated medical risk (singleton at full-term in a head-down position with no other obstetric or medical complications), the risk of death in the first 28 days of life has been cited as 1.77 per 1,000 live births among women who had Caesarean sections, compared to 0.62 per 1,000 for women who delivered vaginally.

Health problems in later life: Birth by Caesarean section also seems to be associated with worse health outcomes later in life, including being overweight or obese and problems in the baby’s immune system.

SO, C-SECTION OR VAGINAL BIRTH?
It all depends on whether there is a real need for it. Most deliveries are ideally best done through vaginal birth methods, but there are exceptions such as the following: abnormal presentation (breech or transverse positions), prolonged labour or a failure to progress (dystocia), foetal distress or cord prolapse, uterine rupture or an elevated risk thereof, hypertension in the mother or baby after amniotic rupture (the waters breaking), large baby weighing more than 4 kgs (macrosomia), umbilical cord abnormalities and other complications or pre-existing conditions and disease.

It is always best to get a second opinion and to ensure that all tests, scans and examinations are done before taking a decision about the birth method. After all, bringing a new life into this world is a delicate event that is fraught with much risk for both mother and baby; it is best to ensure that this event is conducted with the maximum amount of information, assistance and support available. ■